Abstract
Introduction: The HFA-PEFF score is recognized as a simple method to diagnose heart failure (HF) with preserved left ventricular ejection fraction (HFpEF). This study aimed to evaluate the relationship between the score and cardiovascular outcomes in HFpEF patients. Methods: 505 consecutive HFpEF patients were prospectively observed for up to 1,500 days or until the occurrence of cardiovascular events. Cardiovascular outcomes were compared between the HFA-PEFF score 0-4 group (low-intermediate score group) and the HFA-PEFF score 5-6 group (high score group). Overall, 237 cardiovascular events were observed during the follow-up period (median: 1,154 days). Results: Kaplan-Meier analysis showed that there was no significant difference about composite cardiovascular events between low-intermediate score group and high score group (P=0.251), whereas the high score group was at higher risk of HF-related events than the low-intermediate score group (P<0.001). Multivariable Cox proportional hazards analysis with the significant factors from the univariate analysis showed that the HFA-PEFF score (hazard ratio: 1.20, 95% confidence interval: 1.01-1.42, P=0.036) significantly predicted future HF-related events. Receiver operating characteristic analysis showed that the HFA-PEFF score significantly predicted HF-related events (area under the curve, 0.634; 95% CI, 0.575-0.693; P<0.001). The cutoff HFA-PEFF score was 4.5 for the identification of HF-related events. Decision curve analysis revealed that combining HFA-PEFF score with conventional prognostic factors ameliorated risk-prediction of HF-related events. Conclusions: HFA-PEFF score may be useful for predicting HF-related events in HFpEF patients.
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